Virological and immunological stabilisation in AIDS-presenter, regardless antiretroviral therapy

Abstract

Aim of our report is to present and discuss a paradigmatic case report of a patient followed for HIV infection for over twenty years, who, despite the initial diagnosis of AIDS presenter (due to the diagnosis of three episodes of cryptococcal meningo-encephalities, and one episode of pneumocystosis), showed a little or a complete lack of compliance to all the therapeutic regimens, including antiretrovirals, and primary and secondary antimicrobial chemoprophylaxis. Despite the non-compliance during the last three years of follow-up (from poor adherence to voluntary and complete discontinuation of all the therapies) an unexpected clinical-laboratory stabilisation was observed, with progressive increase of CD4+ T-lymphocyte count (range 410 to 825 cells/µl), and HIV viraemia under control (range 5,970-24,000 HIV-RNA copies/ml). This case report arises a number of open questions, concerning the anomalous course of the illness in this patient and the management of non-compliance.